Emerging Infectious Diseases Journal
Highlights: Emerging Infectious Diseases, Vol. 26, No.6, April 2020
The articles of interest summarized below will appear in the June 2020 issue of Emerging Infectious Diseases, CDC’s monthly peer-reviewed public health journal. The articles are embargoed until May 13, 2020, at noon Eastern time.
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1. Origin of 3 Rabid Terrestrial Animals in Raccoon Rabies Virus–Free Zone, Long Island, New York, USA, 2016–2017, Scott Brunt et al.
Raccoon rabies has been common in the eastern United States since 1960 and in New York state since the 1990s. Despite this spread to New York state, two counties on Long Island (Suffolk and Nassau Counties) have been considered raccoon-rabies free since 2011. Maintaining rabies-free areas substantially decreases the likelihood of human and animal exposure to the virus and dramatically reduces the cost of postexposure treatment and control. Thus, detection of three cases of rabies (in a raccoon, a river otter, and an unvaccinated domestic cat) in this area during 2016–2017 prompted an investigation. Had the investigation determined that spread of rabies was a risk in this area, the contingency plan was to distribute bait containing oral rabies vaccine on Long Island. However, genetic analyses (whole-genome sequencing) of the viruses isolated from the three infected animals indicated that they each probably acquired the infection while outside the rabies-free area, deeming it unlikely that the virus was circulating within the area. Enhanced surveillance found no other rabid animals during January 2017–December 2019 in the two counties, and genetic analysis indicated that the rabies virus isolated from the cat was genetically similar to viruses in the county from which the cat had been adopted (50 miles away). Thus, intensified enhanced rabies surveillance and whole-genome sequencing indicated that virus spread in the rabies-free area was unlikely and enabled public health officials to avoid the time and expense of implementing the contingency plan.
Contact: Mr. Jonah Bruno, Director of Communications, NYSDOH, 518-474-7354, Jonah.Bruno@health.ny.gov
2. Risks Related to Chikungunya Infections among European Union Travelers, 2012–2018, Céline M. Gossner et al.
Chikungunya is a virus carried by Aedes mosquitoes and affects people in >100 countries, mostly in the tropics and subtropics. Although chikungunya is not endemic to the European Union (EU), outbreaks have occurred in France and Italy after returning travelers introduced the virus into areas where Aedes albopictus mosquitoes are thriving. In 2008, the EU began chikungunya surveillance in an effort to limit these secondary transmission events. To assess the impact of surveillance, researchers reviewed data on travel-related cases reported in the EU during 2012–2018; they documented factors associated with increased infection rates among travelers and determined how surveillance data could support preparedness against secondary transmission and timely control of outbreaks in susceptible areas. During the study period, 13 EU countries reported a total of 2,616 travel-related chikungunya cases. The researchers concluded that although surveillance of travel-related cases is relevant for estimating the infection risk for travelers and tailoring recommendations for prevention, the data gave no indication that these factors can be useful in estimating the risk for secondary transmission of chikungunya in EU countries.
3. Cannabis Use and Fungal Infections in a Commercially Insured Population, United States, 2016, Kaitlin Benedict et al.
Cannabis can contain fungal pathogens that cause serious and often fatal infections in peoplepeople with immunocompromising conditions, such as cancer, transplant, or infection with HIV. In these patients, some reasons for using cannabis include pain and nausea relief and appetite stimulation. The frequency of fungal infections associated with cannabis is unknown but is a growing concern as more states legalize its medicinal and recreational use. Researchers used health insurance claims data from 2016 to evaluate the prevalence of fungal infection diagnoses among people who use cannabis and people who do not use cannabis and to compare demographic and clinical features between these two groups. They found that people who used cannabis were 3.5 times more likely than people who did not use cannabis to have a fungal infection. Although a causal link between cannabis use and fungal infections cannot be inferred from the results, this study adds to emerging evidence about this association and is consistent with a recommendation that solid organ transplant recipients avoid smoking cannabis. Patients with other immunocompromising conditions should be also aware of the possible link between smoking cannabis and fungal infections and might also consider avoiding this exposure. Physicians should remain aware of the possible link between fungal infections and cannabis use.
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